Abstract Being a food product that contains perishable ingredients and involves a significant degree of manual handling during preparation, sushi is regarded as a potentially hazardous food, which may lead to foodborne disease outbreaks. In Portugal, consumption of takeaway sushi meals has strongly increased throughout the past few years; however, there is limited information regarding its compliance with food quality standards. Under this context, the present study aimed to evaluate the microbiological quality and safety of take-away ready-to-eat sushi meals in Lisbon, Portugal. Sixty-two samples were collected from different origins (restaurant and hypermarket), and each sample was tested for aerobic mesophilic microorganisms, Enterobacteriaceae, Escherichia coli, positive coagulase Staphylococci, presumptive Bacillus cereus count, as for detection of pathogenic microorganisms, such as Salmonella spp., Listeria monocytogenes and Vibrio parahaemolyticus, V. cholerae and V. vulnificus. Results revealed that 48.4% (30/62) were deemed unsatisfactory, 35.5% (22/62) were classified as borderline and only 16.1% (10/62) were considered satisfactory. Even though we did not detect the incidence of potentially pathogenic microorganisms in sushi, the presence of B. cereus and coagulase-positive Staphylococci was detected at unsatisfactory levels. Furthermore, significant differences between the place of origin (restaurant vs. hypermarket) and type of fish were also observed. Overall, the high number of samples classified with a level of microbiological quality “unsatisfactory” and “borderline” highlights the need to review good hygiene practices, as well as the quality of the raw materials used, to obtain a final product with a satisfactory quality and safety level.

Resumo Por ser um género alimentício que contém ingredientes perecíveis e envolve um grau significativo de manipulação manual durante a sua preparação, o sushi é considerado um alimento potencialmente perigoso, que pode causar surtos de doença de origem alimentar. Em Portugal, o consumo de refeições de sushi prontas a consumir tem aumentado ao longo dos últimos anos. No entanto, a informação sobre o cumprimento das normas de qualidade alimentar é limitada. Neste contexto, o presente estudo teve como objetivo avaliar a qualidade e a segurança microbiológica de refeições de sushi prontas para consumo em take-way, na região de Lisboa, Portugal. Foram colhidas 62 amostras de diferentes origens (restaurante e hipermercado), e em cada amostra foi efetuada a contagem de microrganismos aeróbios mesófilos, Enterobacteriaceae, Escherichia coli, estafilococos coagulase positiva, Bacillus cereus presuntivos, e deteção de microrganismos patogénicos, tais como: Salmonella spp., Listeria monocytogenes, Vibrio parahaemolyticus, Vibrio cholerae e Vibrio vulnificus. Os resultados revelaram que 48,4% (30/62) das amostras foram consideradas insatisfatórias, 35,5% (22/62) foram classificadas como “borderline” e apenas 16,1% (10/62) foram consideradas como satisfatórias. Embora não tenham sido detetados microrganismos potencialmente patogénicos nas amostras de sushi, a presença de B. cereus e estafilococos coagulase positivos foram detetados em níveis insatisfatórios. Além disso, também foram observadas diferenças significativas entre o local de origem (restaurante vs. hipermercado) e tipo de peixe.No geral, o elevado número de amostras classificadas com um nível de qualidade microbiológica insatisfatória e “borderline” evidência a necessidade de revisão das boas práticas de higiene, bem como da qualidade das matérias-primas utilizadas, para obter um produto final com qualidade e segurança satisfatória.

Resumo Fundamento: Em doentes com infarto agudo do miocárdio (IAM), choque cardiogênico (CC) e doença multivaso (DMV) persistem dúvidas sobre a intervenção nas artérias não responsáveis. Objetivos: 1) caracterizar a amostra de doentes com IAM, CC e DMV incluídos no Registo Nacional Português de Síndromes Coronárias Agudas (RNSCA); 2) comparar os eventos associados a diferentes estratégias de revascularização; e 3) identificar preditores de mortalidade intra-hospitalar nesta amostra. Métodos: Estudo observacional retrospetivo de doentes com IAM, CC e DMV incluídos no RNSCA entre 2010 e 2018. Compararam-se duas estratégias de revascularização: completa durante o procedimento índice (grupo 1); e completa diferida ou incompleta durante o internamento (grupo 2-3). O endpoint primário foi a ocorrência de reinfarto ou morte intra-hospitalar. A significância estatística foi definida por um valor p < 0,05. Resultados: Identificaram-se 127 doentes com IAM, CC e DMV (18,1% no grupo 1 e 81,9% no grupo 2-3), com idade média de 70 ± 12 anos e 92,9% com IAM com supradesnivelamento do segmento ST. O endpoint primário ocorreu em 47,8% dos doentes do grupo 1 e em 37,5% do grupo 2-3 (p = 0,359). As taxas de mortalidade intra-hospitalar, reinfarto, acidente vascular cerebral e hemorragia major foram também semelhantes nos dois grupos. Os preditores de mortalidade intra-hospitalar nesta amostra foram a presença na admissão de disfunção ventricular esquerda (OR 16,8), bloqueio completo de ramo direito (OR 7,6) e anemia (OR 5,2), (p ≤ 0,02). Conclusões: Entre os doentes com IAM, CC e DMV, incluídos no RNSCA, não se verificou diferença significativa entre revascularização completa no evento índex e completa diferida ou incompleta durante o internamento, relativamente à ocorrência de morte intra-hospitalar ou reinfarto. (Arq Bras Cardiol. 2021; 116(5):867-876)

Abstract Background: In patients with acute myocardial infarction (MI), cardiogenic shock (CS), and multivessel disease (MVD) questions remain unanswered when it comes to intervention on non-culprit arteries. Objective: This article aims to 1) characterize patients with MI, CS and MVD included in the Portuguese Registry on Acute Coronary Syndromes (ProACS); 2) compare different revascularization strategies in the sample; 3) identify predictors of in-hospital mortality among these patients. Methods: Observational retrospective study of patients with MI, CS and MVD included in the ProACS between 2010 and 2018. Two revascularization strategies were compared: complete during the index procedure (group 1); and complete or incomplete during the index hospitalization (groups 2-3). The primary endpoint was a composite of in-hospital death or MI. Statistical significance was defined by a p-value <0.05. Results: We identified 127 patients with MI, CS, and MVD (18.1% in group 1, and 81.9% in groups 2-3), with a mean age of 7012 years, and 92.9% of the sample being diagnosed with ST-segment elevation MI (STEMI). The primary endpoint occurred in 47.8% of the patients in group 1 and 37.5% in group 2-3 (p = 0.359). The rates of in-hospital death, recurrent MI, stroke, and major bleeding were also similar. The predictors of in-hospital death in this sample were the presence of left ventricle systolic dysfunction on admission (OR 16.8), right bundle branch block (OR 7.6), and anemia (OR 5.2) (p ≤ 0.02 for both). Conclusions: Among patients with MI, CS, and MVD included in the ProACS, there was no significant difference between complete and incomplete revascularization during the index hospitalization regarding the occurrence of in-hospital death or MI. (Arq Bras Cardiol. 2021; 116(5):867-876)

Introduction: Tuberous sclerosis complex is an autosomal dominant neurocutaneous disorder which is characterized by multisystem involvement, including the kidney. Since renal disease is one of the causes of morbidity and mortality, close management is essential. Subjects and Methods: In this retrospective observational,single-center study, authors analyse patients with a definite diagnosis of tuberous sclerosis complex who attended Pediatric Nephrology consultation between 1998 and 2019. Results: 20 patients were included. The median age at the time of the diagnosis was 3 years, mostly after seizures and the median age of the first Pediatric Nephrology consultation was 9 years. Seventeen patients had renal disease, the majority with angiomyolipomas and a smaller number with cysts. None had hypertension or history of acute kidney failure. Systemic mTOR inhibitors were used in three patients. Discussion: The present results were similar to those found in the literature regarding presentation features and kidney disease. The authors emphasized the importance of early diagnosis of renal involvement in order to reduce renal morbidity and mortality (especially when these patients reach adulthood) and highlighted the need for early guidance for pediatric nephrology consultation.

Resumo O setor da floricultura é muito atrativo para agricultores familiares, uma vez que demanda pouca área de terra e o ciclo de produção, de grande parte das espécies para esse fim, geralmente é curto. A região do Oeste Catarinense tem grande potencial de crescimento no cultivo de plantas ornamentais, porém, não é o que se observa na prática, havendo pouca ou nenhuma organização da cadeia produtiva desse setor. Desta forma, faz-se necessário estudar as causas dessa problemática. Sendo assim, o objetivo desta pesquisa foi verificar qual é a dinâmica envolvida na produção, comercialização e consumo de plantas ornamentais em Chapecó-SC. O estudo foi realizado no município de Chapecó-SC, por meio de aplicação de entrevistas estruturadas, com produtores rurais, comerciantes e consumidores de flores e plantas ornamentais. O tamanho da amostra da população foi: 45 consumidores, 24 produtores e 18 estabelecimentos comerciais. Foram identificados apenas três produtores de plantas ornamentais em Chapecó. Apenas 21% dos entrevistados pensaram em produzir plantas ornamentais, embora 84% acreditem que o município tenha demanda para os produtos da floricultura. O mercado e a comercialização de plantas ornamentais em Chapecó são altamente dependentes da oferta de produtos vindos do estado de São Paulo, especialmente da região de Holambra. A comercialização predominante é realizada em redes de supermercados, pela facilidade de acesso aos consumidores. O fator preço é o quesito principal na comercialização das plantas ornamentais, e a falta de produtores na região faz com que se elevem os preços, especialmente em função do longo transporte necessário.

Abstract Floriculture is very lucrative to small producers as it requires small land areas, with usually short production cycles. The region of Santa Catarina West in Brazil has growth potential in the cultivation of ornamental plants, although it is not practically observed, as the productive chain of this sector has little or no organization, making it imperative to study the causes of this problem. Therefore, the aim of this study was to characterize the productive chain, market, and commercialization of ornamental plants in Chapecó-SC. The proposed study was carried out in an integrated manner in Chapecó-SC, through structured interviews with farmers, traders, and consumers of flowers and ornamental plants. The study sample consisted of 45 consumers, 24 producers, and 18 commercial establishments. Only three producers of ornamental plants in Chapecó were identified among the participants interviewed, although 84% believed that the municipality has demand for floriculture products, and only 21% of the interviewees have thought about cultivating ornamental plants. The market and commercialization of flowers and ornamental plants in Chapecó are dependent highly on the supply of products from the state of São Paulo, especially form the region of Holambra. The commercialization is predominantly in supermarket chains, for ease of access to consumers. The primary factor affecting the commercialization of ornamental plants is the price, because a dearth of producers in the region leads to an increase in the price, especially due to the long transportation.

Abstract: Background: Kaposi's sarcoma continues to be the most common human immunodeficiency virus - associated neoplasm with considerable morbidity and mortality. Objective: To describe the clinical and laboratory characteristics, initial staging, and outcomes of aids patients with Kaposi's sarcoma at an university hospital of Recife, Pernambuco. Methods: This is a descriptive study with analytic character, retrospective, of a case series between 2004 and 2014. Results: Of the 22 patients included in the study, 20 were aged <40 years (72.7%). The majority had CD4+ T lymphocyte counts of <200 cells/mm3 (77.3%) and human immunodeficiency virus loads of <100,000 copies/mL (78.9%). Lesions were most commonly observed on the skin (90%), and internal organs were affected in 11 of the 22 patients. Only 7 (31.8%) of the 22 patients were undergoing antiretroviral therapy (ART) at the time of Kaposis sarcoma diagnosis, and the initial disease staging classification was high risk (Aids Clinical Trials Group Oncology Committee) in 19 of the 22 patients (86.4%). Regarding Kaposi's sarcoma treatment, 17 of 22 patients (77.3%) underwent systemic chemotherapy + ART and 5 were treated exclusively with ART. Eight of the 22 patients died (36.5%); of these, 87.5% had died within one year of Kaposi's sarcoma diagnosis. Limitation of the study: Without a control group, this study cannot be used to generate hypotheses. Conclusions: Despite the association between aids and late Kaposi's sarcoma diagnosis in the study population, including an unfavorable risk at the time of staging, a lower mortality rate was observed relative to other studies; this might be related to access to a specialized health service.

O presente artigo trata da 'natureza' enquanto objeto da física, ou da ciência natural, tal como descrita por Aristóteles na "Física". Também trata das definições da natureza, especificamente a natureza física, fornecidas por Avicena (m. 1037) e Averróis (m. 1198) nos seus comentários à "Física" de Aristóteles. Avicena e Averróis partilham da conceção da natureza de Aristóteles enquanto princípio de movimento e repouso. Enquanto para Aristóteles o objeto da física parece ser a natureza, ou aquilo que existe por natureza, Avicena defende que é o corpo natural, e Averróis afirma que o objeto da física, ou ciência natural, consiste nas coisas naturais, apresentando uma ênfase algo diferente.

This study is concerned with 'nature' specifically as the subject-matter of physics, or natural science, as described by Aristotle in his "Physics". It also discusses the definitions of nature, and more specifically physical nature, provided by Avicenna (d. 1037) and Averroes (d. 1198) in their commentaries on Aristotle's "Physics". Avicenna and Averroes share Aristotle's conception of nature as a principle of motion and rest. While according to Aristotle the subject matter of physics appears to be nature, or what exists by nature, Avicenna believes that it is the natural body, and Averroes holds that the subject matter of physics or natural science consists in the natural things, in what constitutes a slight shift in focus.